dbMotion’s multi-tier architecture is flexible and scalable, easily adapting to the changing demands of any size organization and diverse IT environments. Each of the architecture layers is designed to optimally perform a variety of functions that facilitate interoperability and health information exchange. It is the framework for effective and efficient communication, as well as for exposing web-services to external consumers.
The Unified Medical Schema (UMS), based on HL7 V3 and the Reference Information Model (RIM), is dbMotion’s data model that, with its vocabulary domain, forms the foundation for semantic interoperability. The UMS enables the aggregation and integration of clinical data into a virtual patient object (VPO) used to mobilize the integrated data to ‘consumers’ such as dbMotion’s web-based clinical viewer and 3rd party applications such as EMRs, physician inboxes, clinical decision support systems and PHRs. The resulting unified and comprehensive patient-centric virtual patient record is viewed by the caregiver as if created by a single, universal system.
The dbMotion Architecture Layers
The Data Integration Layer
The Data Integration Layer is responsible for data acquisition from clinical/operational systems and its transformation into the UMS. Clinical data, irrespective of source or format, is mapped to the UMS, establishing relationships between discrete, patient-specific data elements. This layer aggregates medical information from differently coded systems using
libraries of clinical terminologies/vocabularies, content mapping tools and other elements that integrate, orchestrate and harmonize data.
The Data Layer
The Data Layer is dbMotion’s clinical data repository (CDR), a persistent database responsible for managing and storing patient information retrieved by the Data Integration Layer. The CDR resides within each organization’s physical domain, with data ownership, security and privacy controlled and defined by the organization. This layer also provides a single interface, based on the UMS, for all data retrieval requests, regardless of the original data format, location and collection process.
The Communication Layer
The Communication Layer is responsible for collecting clinical data from the various dbMotion nodes and/or other remote data providers such as pharmacies. Upon request, the Communication Layer collects the relevant data and forms the building blocks of a virtual patient object (VPO). In a federated dbMotion implementation, the Communication Layer’s catalog maps the various data sources of disparate nodes and manages the network’s information flow.
The Business Layer
The Business Layer supplies medical data to its consumer— either a clinical viewer/portal or any 3rd-party application or service. The brain behind the platform’s processes and a key enabler of its SOA capabilities; this layer aggregates, analyzes and integrates medical information according to the consumer’s request using embedded business rules related to data, user role and profile, organization and more. This results in an integrated virtual patient record that can be delivered in various formats.
The Presentation Layer
The Presentation Layer presents integrated medical information at the point of care via dbMotion’s web-based clinical viewer or CareBoard, a physician-focused application that hosts functionalities such as a patient-oriented inbox, alerts, creation of care notes, monitoring of admitted patients, creation of tasks regarding medical events and clinical reminders. Its framework can be integrated into 3rd party applications (EMRs, portals, etc.) ensuring data is delivered within caregivers’ preferred environments and workflows. It also enables data to be consumed by research or analytical applications such as dbMotion SmartWatch, decision support systems and business intelligence applications.
Semantic Services
The semantic services are created by the Semantic Framework and enable the generation of new cross system applications and utilities that are feasible only by leveraging the true meaning of information.
System Management
The System Management Layer incorporates applications and tools for managing dbMotion subsystems, modules
and services; handling configuration, testing and monitoring. Examples include the Event Viewer, a tool for monitoring and configuring system logs and the Security Management Application, a web-based application used to define users, roles, permissions, profiles and more.
Shared Services
dbMotion combines an Enterprise Master Patient Index (EMPI) system with additional technologies to locate and link a patient’s identifiers across multiple systems - a critical prerequisite for interoperability and health information exchange. This overcomes duplicate and fragmented records, multiple identifications, transpositions, misspellings and more.
Security
The Security Layer defines the aggregate of technical and administrative safeguards that prevent prohibited access to electronically Protected Health Information (ePHI) by unauthorized parties inside or outside the organization. Its comprehensive approach to security management includes authorization, authentication, patient consent and secure data transfer, and sophisticated business processes can be applied defining information access. Its services are used throughout the system’s layers, with safeguards implemented through sub-systems, each dealing with a different aspect of information security enabling adherence to a broad array of security standards including HIPAA.
dbMotion™ Unified Medical Schema™
With patient data typically dispersed over a wide array of disparate clinical/operational systems, languages, and data structures, the only way to maintain a unified medical record without the need to adapt these different environments is to focus completely on the patient. This is what dbMotion offers with the Unified Medical Schema (UMS) data model, an important cornerstone of the dbMotion Solution.
This schema defines all the relevant information elements that constitute the dbMotion patient record and the logical relationships between them. With logical relationships, there is no dependence on, or relationship with, the type, structure, or quantity of the clinical/operational systems from which this information is aggregated. The schema is an independent information model designed to define, structure, link, and rationalize all patient medical record data within the healthcare enterprise, working with all source clinical information system regardless of how and where the data is generated.
The schema is based on the HL7 V3 Reference Information Model (RIM), supporting current enterprise data requirements and serving as a platform for a broad spectrum of future requirements.
The schema serves as the basis for the abstraction between the physical layer (the Data Layer) and the logical layer (the Business Layer). All data in the Data Layer (content and structure) is mapped and converted to the UMS by Data Integration Layer tools, creating the unified medical record.